Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of California, San Diego, San Diego, CA.
Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, VA San Diego Healthcare System, La Jolla, CA.
Int Forum Allergy Rhinol. 2017 Dec;7(12):1201-1206. doi: 10.1002/alr.22023. Epub 2017 Oct 12.
Isolated sphenoid sinus opacifications (ISSOs) represent a relatively uncommon disease with the potential for serious complications. To better understand this disease, we performed a systematic review to further characterize the underlying pathologies, associated symptoms, and treatment outcomes of patients with ISSOs.
A systematic review of ISSO case series was performed utilizing the Medline, Embase, Web of Science, and Cochrane databases in accordance with guidelines established by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Data of interest included disease pathology, associated symptoms, and treatment outcomes.
Of the initial 1051 hits from the 4 databases, 17 articles, with a combined 1133 ISSO patients, were ultimately included in the review. On a weighted analysis, the underlying pathologies were classified as chronic rhinosinusitis without nasal polyps (CRSsNP) (28.3%), mucoceles (20.3%), fungal sinusitis (12.5%), malignant neoplasms (7.7%), intracranial lesions (7.0%), benign neoplasms (5.7%), chronic rhinosinusitis with nasal polyps (CRSwNP) (3.4%), and other lesions (4.7%). Cranial neuropathies were present in 16.3% (95% confidence interval [CI], 10.1-22.5%) of ISSO patients. A favorable surgical complication rate of 1.5% (95% CI, -0.1% to 3.2%) was found in patients undergoing surgery for an ISSO.
ISSOs are caused by diverse pathologies. Given the considerable rates of neoplastic disease and cranial neuropathies, patients affected by an ISSO should be monitored closely and treated aggressively. Prompt surgical intervention, with either diagnostic or therapeutic intent, is often indicated.
孤立性蝶窦混浊（ISSO）是一种相对罕见的疾病，可能导致严重的并发症。为了更好地了解这种疾病，我们进行了系统评价，以进一步描述 ISSO 患者的潜在病理、相关症状和治疗结果。
根据 PRISMA（系统评价和荟萃分析的首选报告项目）制定的指南，利用 Medline、Embase、Web of Science 和 Cochrane 数据库对 ISSO 病例系列进行系统评价。感兴趣的数据包括疾病病理学、相关症状和治疗结果。
从 4 个数据库中最初的 1051 个命中中，最终有 17 篇文章，共 1133 例 ISSO 患者被纳入综述。在加权分析中，潜在的病理分为慢性鼻-鼻窦炎不伴鼻息肉（CRSsNP）（28.3%）、黏液囊肿（20.3%）、真菌性鼻窦炎（12.5%）、恶性肿瘤（7.7%）、颅内病变（7.0%）、良性肿瘤（5.7%）、慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）（3.4%）和其他病变（4.7%）。16.3%（95%置信区间 [CI]，10.1-22.5%）的 ISSO 患者存在颅神经病变。对 ISSO 患者进行手术治疗的患者，手术并发症发生率为 1.5%（95%CI，-0.1%至 3.2%）。
ISSO 是由多种病理引起的。鉴于相当比例的肿瘤性疾病和颅神经病变，受 ISSO 影响的患者应密切监测并积极治疗。通常需要及时进行手术干预，无论是诊断性还是治疗性的。
